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The bidirectional relationship between sleep problems and internalizing and externalizing problems in children with

Melissa Mulraney1, Rebecca Giallo2, Kate Lycett3

  • 1Community Child Health, Murdoch Childrens Research Institute, 50 Flemington Road, Parkville, Victoria, Australia.

Sleep Medicine
|February 6, 2016
PubMed

Insights

In children with attention deficit hyperactivity disorder (ADHD), sleep problems and emotional issues show a weak bidirectional link. Targeting both may improve overall functioning in children with ADHD.

Area of Science:

  • Child and Adolescent Psychiatry
  • Developmental Psychology
  • Sleep Medicine

Background:

  • Behavioral sleep problems are prevalent in children with attention deficit hyperactivity disorder (ADHD).
  • Longitudinal studies indicate sleep issues can predict and result from internalizing and externalizing problems.

Purpose of the Study:

  • To investigate the potential bidirectional relationship between sleep problems and internalizing/externalizing problems in children with ADHD.

Main Methods:

  • Recruited 270 children with ADHD (aged 5-13) from Australian pediatric practices.
  • Collected parent-reported data on sleep and emotional/behavioral functioning over 12 months at three time points.
  • Utilized autoregressive cross-lagged panel models for data analysis.

Main Results:

  • Sleep and emotional/behavioral problems demonstrated high stability over the 12-month study period.
  • Sleep problems at baseline predicted emotional problems at six months (r=0.17, p<0.01).
  • Emotional problems at baseline predicted sleep problems at six months (r=0.07, p<0.05), with no significant predictive relationship observed between 6-12 months or for conduct problems.

Conclusions:

  • Weak evidence suggests a bidirectional relationship between sleep and emotional problems in children with ADHD.
  • Given the stability of these symptoms, integrated treatment targeting both sleep and emotional functioning is recommended.
  • This approach may enhance overall functioning in children with ADHD.
Abstract

Keywords:
ADHDExternalizingInternalizingSleep

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